Periodontal disease, or tooth and gum disease, is one of the most prevalent health disorders in dogs and cats. Studies have shown that most canines show some signs of this disease by 3 years of age. Early signs can include tender, swollen gums, and, most commonly, bad breath. More importantly, though, if left untreated, periodontal disease can lead to secondary disease conditions that can seriously threaten the health of affected pets.

 

It all begins with the formation of plaque on tooth surfaces. This plaque is merely a thin film of food particles and bacteria. Over time, however, plaque mineralizes and hardens to form calculus. Owners who lift up their pet’s lip and glance at its teeth, especially near the gumline, might notice brownish to yellowish buildup of calculus on the outer surface of the teeth.

Calculus tends to accumulate worse on the outer surface of the large fourth upper premolars and on the inner surfaces of the lower incisors and premolars. This is because canine saliva is conducive to calculus formation, and the ducts from the salivary glands empty into the mouth at these particular sites. Buildup of this substance tends to be worse in smaller breeds of dogs, such as miniature poodles, Yorkshire terriers, Maltese, and schnauzers. In fact, it is not at all unusual for some of these dogs to start losing teeth by 4 to 5 years of age without at-home preventive dental care.

Along with these breed predispositions, diet can play an important role in the development of periodontal disease. For instance, moist foods high in sugar content promote plaque formation much more readily than do the dry varieties. In addition, diets containing too much phosphorus (such as all-meat rations) have been linked to periodontal disease.

Certain underlying disease conditions might also promote periodontal disease as a side effect. For example, hypothyroidism can lead to gingivitis and dental complications associated with it. Periodontal disease can also occur incidentally with tumors involving the gum tissue and/or teeth.

Pets suffering from periodontal disease can exhibit a diverse selection of clinical signs. Early periodontal disease might be marked only by a decreased appetite due to swollen, painful gums. Pet owners often complain of bad breath in their pets, and might notice signs of gagging or retching as secondary tonsillitis sets in.

As the disease progresses, these signs might worsen, and other symptoms, such as gum recession, gum bleeding, and tooth loss, might arise. Infected teeth that do not fall out can form abscesses, marked by sinus infections, nasal discharges, and/or draining tracts appearing on the face.

But the damage caused by periodontal disease doesn’t stop there. Bacteria can gain entrance into the bloodstream by way of the teeth and gums, seeding the body with infectious organisms. In advanced cases, these bacteria can overwhelm the host’s immune system and set up housekeeping on the valves of the heart. The resulting valvular endocarditis in turn can lead to heart murmurs and eventual heart failure. Besides the heart, the bacteria that gain access to the body because of periodontal disease can lodge in the kidney, causing infection, inflammation, and acute damage. Over time, signs related to kidney failure might develop in affected pets.

Early cases of periodontal disease can be treated by a thorough scaling and polishing of the teeth to remove the offending calculus. This scaling needs to be professionally performed under sedation or anesthesia to ensure complete removal of the calculus under the gumline.

Using special instruments to hand-scale a pet’s teeth at home without anesthesia is not only dangerous but also highly ineffective at cleaning the teeth where it counts the most, up under the gumline. Furthermore, such scaling, if not followed by polishing, will leave etches in the enamel covering of the teeth that can serve as foci for future plaque and calculus buildup.

Antibiotics will also be prescribed for dogs and cats suffering from moderate to advanced periodontal disease to combat the associated bacterial infection. Teeth that are excessively loose within their sockets serve only to propagate infection, and should be extracted. For infected teeth that are still deemed viable, a root canal can be performed as a salvage procedure. See Chapter 4 for prevention tips to help protect pets against the adverse effects of periodontal disease.